Type of Surgery
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Last updated: 11/24/2009
A cholecystectomy is performed to treat cholelithiasis and cholecystitis. In cholelithiasis, gallstones of varying shapes and sizes form from the solid components of bile. The presence of these stones, often referred to as gallbladder disease, may...
produce symptoms of excruciating right upper abdominal pain radiating to the right shoulder. The gallbladder may become the site of acute infection and inflammation, resulting in symptoms of upper right abdominal pain, nausea, and vomiting. This condition is referred to as cholecystitis. The surgical removal of the gallbladder can provide relief of these symptoms. Cholecystectomy is used to treat both acute and chronic cholecystitis when there are significant pain symptoms. The typical composition of gallstones is predominately cholesterol, or a compound called calcium bilirubinate.
Cholelithiasis
Most patients with cholelithiasis have no significant physical symptoms. Approximately 80% of gallstones do not cause significant discomfort. Patients who develop biliary colic generally do have some symptoms. When gallstones obstruct the cystic duct, intermittent, extreme, cramping pain typically develops in the right upper quadrant of the abdomen. This pain generally occurs at night and can last from a few minutes to several hours. An acute attack of cholecystitis is often associated with the consumption of a large, high-fat meal.
The medical management of gallstones depends to a great degree on the presentation of the patient. Patients with no symptoms generally do not require any medical treatment. The best treatment for patients with symptoms is usually surgery. Laparoscopic cholecystectomy is typically preferred over the open surgical approach because of the decreased recovery period. Patients who are not good candidates for either type of surgery can obtain some symptom relief with drugs, especially oral bile salts.
Cholecystitis
Cholecystitis is an inflammation of the gallbladder, both acute and chronic, that results after the development of gallstones in some individuals. The most common symptoms and physical findings associated with cholecystitis include:
- pain and tenderness in the upper right quadrant of the abdomen
- nausea
- vomiting
- fever
- jaundice
- history of pain after eating large, high-fat meals
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This video shows precisely what a surgeon sees during a laparoscopic cholescystectomy. A laparoscopic cholescystectomy is gallbladder removal surgery using small incisions and cameras rather than a large abdominal incision. This video may be difficult for some viewers since it shows surgery on actual human tissue.
In a laparoscopic cholecystectomy, four small incisions are made in the abdomen (A). The abdomen is filled with carbon dioxide, and the surgeon views internal structures with a video monitor (B). The gallbladder is located and cut with laparoscopic scissors (C). It is then removed through an incision (D). (Illustration by GGS Inc.)
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Cholecystectomy (pronounced /ˌkɔləsɪsˈtɛktəmi/, plural: cholecystectomies) is the surgical removal of the gallbladder. Despite the development of non-surgical techniques, it is the most common method for treating symptomatic gallstones, although there are other indications for the procedure, including carcinoma. Each year more than 500,000 Americans have gallbladder surgery. Surgery options include the standard procedure, called laparoscopic cholecystectomy, and an older more invasive procedure, called open cholecystectomy. A cholecystectomy is performed when attempts to treat gallstones with ultrasound to shatter the stones (lithotripsy) or medications to dissolve them have not proved feasible.
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